The Importance of Voluntary Behavior in Rehabilitation Treatment and Outcomes |
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Authors: | John Whyte Marcel P. Dijkers Tessa Hart Jarrad H. Van Stan Andrew Packel Lyn S. Turkstra Jeanne M. Zanca Christine Chen Mary Ferraro |
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Affiliation: | 1. Moss Rehabilitation Research Institute, Elkins Park, PA;2. Wayne State University, Detroit, MI;3. Icahn School of Medicine at Mount Sinai, New York, NY;4. Harvard Medical School, Boston, MA;5. Massachusetts General Hospital Center for Laryngeal Surgery and Voice Rehabilitation, Boston, MA;6. MGH Institute of Health Professions, Charlestown, MA;7. McMaster University, Hamilton, Ontario, Canada;8. Kessler Foundation, West Orange, NJ;9. Texas Woman’s University, Denton, TX |
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Abstract: | Most rehabilitation treatments are volitional in nature, meaning that they require the patient’s active engagement and effort. Volitional treatments are particularly challenging to define in a standardized fashion, because the clinician is not in complete control of the patient’s role in enacting these treatments. Current recommendations for describing treatments in research reports fail to distinguish between 2 fundamentally different aspects of treatment design: the selection of treatment ingredients to produce the desired functional change and the selection of ingredients that will ensure the patient’s volitional performance. The Rehabilitation Treatment Specification System (RTSS) is a conceptual scheme for standardizing the way that rehabilitation treatments are defined by all disciplines across all areas of rehabilitation. The RTSS highlights the importance of volitional behavior in many treatment areas and provides specific guidance for how volitional treatments should be specified. In doing so, it suggests important crosscutting research questions about the nature of volitional behavior, factors that make it more or less likely to occur, and ingredients that are most effective in ensuring that patients perform desired treatment activities. |
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Keywords: | Classification Patient outcome assessment Patient participation Rehabilitation Therapeutics Treatment efficacy Volition COM-B Capability, Opportunity, Motivation and Behavior RTSS Rehabilitation Treatment Specification System VR virtual reality |
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